Trail of Remembrance

American Charter Academy’s 12th Annual Trail of Remembrance Saturday, April 25, 2015

REGISTRATION

Name: ______Age: ______

Address: ______

Phone: ______E-Mail: ______

Veteran Honoree: ______

Additional Honoree ($10.00):______Veteran’s name will appear on a sign and displayed along the “Trail” each year. (Same day registration~ Signs will be posted next year.) REGISTRATION STARTS AT 10:00 AM.

Please make checks payable to A me ric a n C h a rter A c a de m y. Credit cards will be accepted. If using a credit card please provide the following information as it appears on the card:

Name Billing Address CC Type ______

CC#______3 Digit CVV#_____Exp. Date ______Phone #______Donations: $ ______ Early Registration (before Feb. 20th 2015) $30 ------Students (age 18 and below) $15

 Pre-Registration (before Aril 25, 2015) $35 ------Students (age 18 and below) $20

 Day of Trail (on April 25, 2015) $40 ------Students (age 18 and below) $28

Please Circle your shirt size: Small Medium Large X Large XX Large

Please check the box next to the event you will be participating in.

Bikers - Start at 11:00 a.m. Runners - Start at 11:15a.m. (timed) Walkers - Start at 11:30a.m.

**Our Registration and Ready Area co-located at the start of the 5K (3.1 miles), Mile 52 of the Parks Highway. The tent, balloons and sign will make us easy to find.

BBQ at American Charter Academy will begin at 11:30 serving participants and volunteers.

School Waiver: I am participating in the 12th Annual American Charter Academy’s Trail of Remembrance. I testify that I have full knowledge of the risk involved in this event, and that I am physically fit to participate in this event. I agree to indemnify all sponsors who are associated with this event, their offices and agents against all claims, loss, or liability whatsoever arising from this agreement or the performance of this agreement including, but not limited to damage or destruction of any property or injury or death to said person or any person including such claims, losses, or liability whether passive or active of indemnities. I understand that any and all fees paid by me are nonrefundable.

______Signature (Parent or Guardian if under 18 years of age) Date

M a il , F a x or E-mail t o : Drop O f f t o : American Charter Academy American Charter Academy 7361 W. Parks Hwy, #725 Meadow Lakes City Center at Parks & Pittman Wasilla, AK 99623 (Entry is in the back of the building) Office: (907) 352-0150 Wasilla, AK 99623 Fax: (907) 352-0180 E-mail: [email protected]